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By 姜 徳相

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Graffiti and Dipinti (Athenian Agora vol. 21)

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Patients may also develop GO in the absence of hyperthyroidism and never develop the high circulating thyroid hormone levels at all. This euthyroid GO Lazarus/Marino 28 (also called ophthalmic Graves’ disease) occurs in 5–10% of patients. However, when these patients are extensively evaluated they are often found to have some features of thyroid disease, ranging from a positive family history through to the presence of TSH-receptor-stimulating antibodies. In addition, they may have isolated positive TPO antibodies or an abnormal response to TRH.

Konuk O, Atasever T, Mehmet U, Ayvaz G, Yetkin I, Cakir N, Arslan M, Hasanreisoglu B: Orbital gallium-67 scintigraphy in Graves’ ophthalmopathy: a disease activity parameter that predicts the therapeutic response to immunosuppressive treatment. Thyroid 2005;15:358–363. Gerding MN, Prummel MF, Wiersinga WM: Assessment of disease activity in Graves’ ophthalmopathy by orbital ultrasonography and clinical parameters. Clin Endocrinol 2000;52:641–646. Terwee CB, Prummel MF, Gerding MN, Kahaly GJ, Dekker FW, Wiersinga WM: Measuring disease activity to predict therapeutic outcome in Graves’ ophthalmopathy.

Clinical Manifestations 21 Can Dysthyroid Optic Neuropathy Ever Be Present with Normal Vision? There is clear evidence that DON can be present with normal vision [3, 24]. 0 may represent a reduction on their normal acuity, while others will truly have no objective reduction by the time DON is diagnosed. 5 or better [61, 65, 66]. Are Some Patients at Particular Risk? There is a higher risk of DON in men, and in older patients of either gender. The mean age at presentation of DON is 56–57 years [23, 24] whereas for GO without DON it is 49 years [17, 23].

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